R. Rahimisadegh, A. Haghdoost, S. Emadi, S. N. Hekmat
Background: The health sector evolution plan was implemented in 2014 in government hospitals across the country as a part of the universal health coverage achievement programs. This study assessed the performance of hospitals before and after the implementation of this plan, using the Pabon Lasso model. Methods: The population of this study consisted of the hospitals of the country in the 2013-2015 time frame; overall, 874 hospitals (94.5% of the population) were included in the study. In order to assess performance, we used the Pabon Lasso model and hospital performance indicators (Average Length of Stay, Bed Turnover, and Bed Occupancy Rate). The data were collected from the Hospital Information System and provincial deputies of curative affairs and were then analyzed using the descriptive indicators of mean, frequency, and median in SPSS 22. Also, Paired Student T-test and ANOVA were used to compare the performance of different groups of hospitals before and after the implementation of the health sector evolution plan. Results: The implementation of the health sector evolution plan has led to a significant improvement in the three performance indicators in the hospitals of the country. Before the implementation of the health sector evolution plan, the most inefficient, inefficient, fairly efficient, and most efficient zones included 31%, 18%, 17%, and 33% of the studied hospitals, respectively. However, the implementation of the health sector evolution plan changed the percentages to 29%, 21%, 20%, and 30%, respectively. Teaching hospitals, which are governmental and are mostly located in capital cities of the provinces, were overall more inefficient than nonteaching hospitals. Conclusion: The number of the most efficient and most inefficient hospitals has decreased, and the number of average performance hospitals has increased after the implementation of the health sector evolution plan. Therefore, the health sector evolution plan has not led to an overall increase or decrease in the performance of hospitals but has reduced the difference in the performance of hospitals. Equal support of government hospitals along with financial protection against health expenses, improves the performance indicators of hospitals and reduces performance differences among them.
{"title":"Assessing the performance of hospitals before and after the implementation of Iran’s Health Sector Evolution Plan (HSEP)using the Pabon Lasso model","authors":"R. Rahimisadegh, A. Haghdoost, S. Emadi, S. N. Hekmat","doi":"10.34171/MJIRI.35.23","DOIUrl":"https://doi.org/10.34171/MJIRI.35.23","url":null,"abstract":"Background: The health sector evolution plan was implemented in 2014 in government hospitals across the country as a part of the universal health coverage achievement programs. This study assessed the performance of hospitals before and after the implementation of this plan, using the Pabon Lasso model. Methods: The population of this study consisted of the hospitals of the country in the 2013-2015 time frame; overall, 874 hospitals (94.5% of the population) were included in the study. In order to assess performance, we used the Pabon Lasso model and hospital performance indicators (Average Length of Stay, Bed Turnover, and Bed Occupancy Rate). The data were collected from the Hospital Information System and provincial deputies of curative affairs and were then analyzed using the descriptive indicators of mean, frequency, and median in SPSS 22. Also, Paired Student T-test and ANOVA were used to compare the performance of different groups of hospitals before and after the implementation of the health sector evolution plan. Results: The implementation of the health sector evolution plan has led to a significant improvement in the three performance indicators in the hospitals of the country. Before the implementation of the health sector evolution plan, the most inefficient, inefficient, fairly efficient, and most efficient zones included 31%, 18%, 17%, and 33% of the studied hospitals, respectively. However, the implementation of the health sector evolution plan changed the percentages to 29%, 21%, 20%, and 30%, respectively. Teaching hospitals, which are governmental and are mostly located in capital cities of the provinces, were overall more inefficient than nonteaching hospitals. Conclusion: The number of the most efficient and most inefficient hospitals has decreased, and the number of average performance hospitals has increased after the implementation of the health sector evolution plan. Therefore, the health sector evolution plan has not led to an overall increase or decrease in the performance of hospitals but has reduced the difference in the performance of hospitals. Equal support of government hospitals along with financial protection against health expenses, improves the performance indicators of hospitals and reduces performance differences among them.","PeriodicalId":22988,"journal":{"name":"The Medical Journal of The Islamic Republic of Iran","volume":"12 9 1","pages":"161-168"},"PeriodicalIF":0.0,"publicationDate":"2021-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77058572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: One of the important aspects in the field of refugee health is the availability of primary health care, and the quality improvement of health care requires identifying barriers and facilitators. The present study aimed to identify obstacles and facilitators of providing primary health care to Afghan refugees from the perspective of health care providers. Methods: In this qualitative study, a semi-structured interview was conducted based on purposeful sampling with the involvement of 21 managers and experts in primary health care centers. Data were analyzed using the content analysis method and MaxQDA. Results: Data analysis led to the production of 4 main themes: (1) challenges while providing primary health care, with 10 subthemes; (2) challenges after providing care, with 4 subthemes; (3) opportunities, with 3 subthemes; and (4) solutions, with 6 subthemes. Conclusion: According to the results of this study, identifying the challenges and providing opportunities and solutions to existing problems seem to be effective steps in the quality improvement of providing primary health care to refugees.
{"title":"Barriers and facilitators of providing primary health care to Afghan refugees: A qualitative study from the perspective of health care providers.","authors":"N. Azizi, B. Delgoshaei, A. Aryankhesal","doi":"10.34171/MJIRI.35.1","DOIUrl":"https://doi.org/10.34171/MJIRI.35.1","url":null,"abstract":"Background: One of the important aspects in the field of refugee health is the availability of primary health care, and the quality improvement of health care requires identifying barriers and facilitators. The present study aimed to identify obstacles and facilitators of providing primary health care to Afghan refugees from the perspective of health care providers. Methods: In this qualitative study, a semi-structured interview was conducted based on purposeful sampling with the involvement of 21 managers and experts in primary health care centers. Data were analyzed using the content analysis method and MaxQDA. Results: Data analysis led to the production of 4 main themes: (1) challenges while providing primary health care, with 10 subthemes; (2) challenges after providing care, with 4 subthemes; (3) opportunities, with 3 subthemes; and (4) solutions, with 6 subthemes. Conclusion: According to the results of this study, identifying the challenges and providing opportunities and solutions to existing problems seem to be effective steps in the quality improvement of providing primary health care to refugees.","PeriodicalId":22988,"journal":{"name":"The Medical Journal of The Islamic Republic of Iran","volume":"217 1","pages":"1-1"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79693881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marjan Mirzania, A. Khajavi, Akram Kharazmi, M. Moshki
Background: Main health challenge of the 21st century is improving quality of life (QoL). This study aimed to investigate the mediating role of health locus of control (HLC) between health literacy and QoL among Iranian pregnant women. Methods: In this cross sectional survey, 400 pregnant women referred to the community health centers of Gonabad, Iran, and completed the demographic, health literacy, QoL, and multidimensional HLC questionnaires during 2015-2016. Descriptive statistics and structural equation modeling were conducted using SPSS 22.0 version and AMOS 24.0 software. Results: The findings showed that health literacy has a significant positive effect on the physical (β= 0.54, p< 0.001) and mental (β= 0.57, p< 0.001) health. Also, it has a significant positive effect on internal subscale (β= 0.42, p< 0.001) and a significant negative effect on the chance (β= -0.51, p< 0.001) and powerful others (β= -0.33, p< 0.001) subscale of HLC. From HLC subscales, internal HLC had a significant positive effect on physical (β= 0.26, p< 0.001) and mental (β= 0.12, p= 0.010) health, while the effects of chance and powerful others on QoL dimensions were not significant. The findings indicated that internal HLC is a partial mediator between health literacy and physical dimension of QoL. Conclusion: The results indicate that health literacy can be considered as an effective factor in HLC orientations and can improve QoL. This reflects the need for more attention on health literacy and the recognition of the type of HLC beliefs, especially the internal belief in health promotion programs for pregnant women.
{"title":"Health literacy and quality of life among Iranian pregnant women: The mediating role of health locus of control.","authors":"Marjan Mirzania, A. Khajavi, Akram Kharazmi, M. Moshki","doi":"10.34171/MJIRI.34.161","DOIUrl":"https://doi.org/10.34171/MJIRI.34.161","url":null,"abstract":"Background: Main health challenge of the 21st century is improving quality of life (QoL). This study aimed to investigate the mediating role of health locus of control (HLC) between health literacy and QoL among Iranian pregnant women. Methods: In this cross sectional survey, 400 pregnant women referred to the community health centers of Gonabad, Iran, and completed the demographic, health literacy, QoL, and multidimensional HLC questionnaires during 2015-2016. Descriptive statistics and structural equation modeling were conducted using SPSS 22.0 version and AMOS 24.0 software. Results: The findings showed that health literacy has a significant positive effect on the physical (β= 0.54, p< 0.001) and mental (β= 0.57, p< 0.001) health. Also, it has a significant positive effect on internal subscale (β= 0.42, p< 0.001) and a significant negative effect on the chance (β= -0.51, p< 0.001) and powerful others (β= -0.33, p< 0.001) subscale of HLC. From HLC subscales, internal HLC had a significant positive effect on physical (β= 0.26, p< 0.001) and mental (β= 0.12, p= 0.010) health, while the effects of chance and powerful others on QoL dimensions were not significant. The findings indicated that internal HLC is a partial mediator between health literacy and physical dimension of QoL. Conclusion: The results indicate that health literacy can be considered as an effective factor in HLC orientations and can improve QoL. This reflects the need for more attention on health literacy and the recognition of the type of HLC beliefs, especially the internal belief in health promotion programs for pregnant women.","PeriodicalId":22988,"journal":{"name":"The Medical Journal of The Islamic Republic of Iran","volume":"35 1","pages":"161-161"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86495217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The construct of satisfaction with life has been studied across various cultures through the Satisfaction with Life Scale. The Satisfaction with Life Scale (SWLS) has been validated across several populations and languages. There are no published psychometric properties of its Urdu version. Hence, the aim of this study was to ascertain the psychometric properties of the Urdu version of the SWLS among the Urdu speaking population of Pakistan. Methods: The SWLS has already been translated into Urdu, and the Urdu version is available on the author's website however there is no information about its psychometric properties. To establish the psychometric properties especially the factor structure of the already translated Urdu SWLS, the SWLS-Urdu was administered to Urdu speaking population residing in Pakistan. The statistical analyses (i.e., normality through skewness and kurtosis, Kaiser-Meyer-Olkin (KMO) and Bartlett's test of sphericity, and test and re-test reliability) were conducted through SPSS version 25.0. Structure Equation Modelling via maximum likelihood method of estimation was used to perform confirmatory factor analysis on the data using AMOS 20.0. The significance level was set at p < 0.05. Results: The study was completed by recruiting 120 participants from different universities in Lahore, Pakistan. The sample was equally divided between male and female participants. The mean age of participants was 22.7(3.6) years. Test of the adequacy of the sample through Kaiser-Mayer-Olkin showed KMO=0.88 and Bartlett's test of sphericity (p<0.001). The Cronbach's alpha reliability of the scale was 0.90 and Confirmatory Factor Analysis confirmed a one-factor model as a good fit with strong statistical evidence. No factorial group variances were noticed in male and female participants. Conclusion: This study shows that Urdu SWLS has sound psychometric properties, is linguistically and culturally acceptable, and equally useful in assessing satisfaction with life in the Urdu speaking population.
{"title":"The satisfaction with life scale: Psychometric properties in Pakistani population.","authors":"Nadia Barki, F. R. Choudhry, Khadeeja Munawar","doi":"10.34171/MJIRI.34.159","DOIUrl":"https://doi.org/10.34171/MJIRI.34.159","url":null,"abstract":"Background: The construct of satisfaction with life has been studied across various cultures through the Satisfaction with Life Scale. The Satisfaction with Life Scale (SWLS) has been validated across several populations and languages. There are no published psychometric properties of its Urdu version. Hence, the aim of this study was to ascertain the psychometric properties of the Urdu version of the SWLS among the Urdu speaking population of Pakistan. Methods: The SWLS has already been translated into Urdu, and the Urdu version is available on the author's website however there is no information about its psychometric properties. To establish the psychometric properties especially the factor structure of the already translated Urdu SWLS, the SWLS-Urdu was administered to Urdu speaking population residing in Pakistan. The statistical analyses (i.e., normality through skewness and kurtosis, Kaiser-Meyer-Olkin (KMO) and Bartlett's test of sphericity, and test and re-test reliability) were conducted through SPSS version 25.0. Structure Equation Modelling via maximum likelihood method of estimation was used to perform confirmatory factor analysis on the data using AMOS 20.0. The significance level was set at p < 0.05. Results: The study was completed by recruiting 120 participants from different universities in Lahore, Pakistan. The sample was equally divided between male and female participants. The mean age of participants was 22.7(3.6) years. Test of the adequacy of the sample through Kaiser-Mayer-Olkin showed KMO=0.88 and Bartlett's test of sphericity (p<0.001). The Cronbach's alpha reliability of the scale was 0.90 and Confirmatory Factor Analysis confirmed a one-factor model as a good fit with strong statistical evidence. No factorial group variances were noticed in male and female participants. Conclusion: This study shows that Urdu SWLS has sound psychometric properties, is linguistically and culturally acceptable, and equally useful in assessing satisfaction with life in the Urdu speaking population.","PeriodicalId":22988,"journal":{"name":"The Medical Journal of The Islamic Republic of Iran","volume":"1 1","pages":"159-159"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80007341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. A. Gharaei, S. Nematollahi, Hossein Moameri, A. Madani, M. Parsaeian, K. Holakouie-Naieni
Background: Due to the controversial effects of mental health disorders during pregnancy on infant health, the present study aimed to evaluate the effect of gestational depression, stress, and anxiety on the growth of offspring at six months of age in disadvantaged communities in South of Iran. Methods: The sample comprised of 470 pregnant women (response rate=98%) who are participated in the Bandar Abbas Pregnancy Cohort study. Maternal mental health was measured by the DASS-21 questionnaire during pregnancy. Data on infant growth was collected based on infant`s growth chart at six months of age. The relative risk of suboptimal infant growth was calculated by Modified Poisson regression models at 5% significant level. Results: The prevalence of depression, anxiety, and stress was 19.0%, 26.1% and 6.5%, respectively. At six months of age, the mean (SD) of infant`s weight (gram), height (cm) and head circumference (cm) were 7287.30 (1019.85), 63.23 (5.62) and 41.39 (2.70), respectively. Compared to normal mothers, the risk of suboptimal weight at six months of age significantly increased by 71% in mothers who were classified as having depression (Adjusted RR: 1.71, 95% CI: 1.07, 2.09). The presence of anxiety significantly increased the risk of suboptimal height at six months of age by 43% (ARR: 1.43, 95% CI: 1.07, 1.92). There were no statistically significant effects of either depression anxiety or stress on the suboptimal head circumference at six months of age. Conclusion: Our results showed that mental health disorders of pregnant women might adversely influence the weight and height growth of offspring within the first six months of age. Screening protocols to early diagnose of mental health disorders during pregnancy, and to strict follow up of diagnosed cases postpartum are proposed.
{"title":"Effect of maternal mental health during pregnancy on infant growth at six months of age in Suburban communities in South of Iran.","authors":"H. A. Gharaei, S. Nematollahi, Hossein Moameri, A. Madani, M. Parsaeian, K. Holakouie-Naieni","doi":"10.34171/MJIRI.34.157","DOIUrl":"https://doi.org/10.34171/MJIRI.34.157","url":null,"abstract":"Background: Due to the controversial effects of mental health disorders during pregnancy on infant health, the present study aimed to evaluate the effect of gestational depression, stress, and anxiety on the growth of offspring at six months of age in disadvantaged communities in South of Iran. Methods: The sample comprised of 470 pregnant women (response rate=98%) who are participated in the Bandar Abbas Pregnancy Cohort study. Maternal mental health was measured by the DASS-21 questionnaire during pregnancy. Data on infant growth was collected based on infant`s growth chart at six months of age. The relative risk of suboptimal infant growth was calculated by Modified Poisson regression models at 5% significant level. Results: The prevalence of depression, anxiety, and stress was 19.0%, 26.1% and 6.5%, respectively. At six months of age, the mean (SD) of infant`s weight (gram), height (cm) and head circumference (cm) were 7287.30 (1019.85), 63.23 (5.62) and 41.39 (2.70), respectively. Compared to normal mothers, the risk of suboptimal weight at six months of age significantly increased by 71% in mothers who were classified as having depression (Adjusted RR: 1.71, 95% CI: 1.07, 2.09). The presence of anxiety significantly increased the risk of suboptimal height at six months of age by 43% (ARR: 1.43, 95% CI: 1.07, 1.92). There were no statistically significant effects of either depression anxiety or stress on the suboptimal head circumference at six months of age. Conclusion: Our results showed that mental health disorders of pregnant women might adversely influence the weight and height growth of offspring within the first six months of age. Screening protocols to early diagnose of mental health disorders during pregnancy, and to strict follow up of diagnosed cases postpartum are proposed.","PeriodicalId":22988,"journal":{"name":"The Medical Journal of The Islamic Republic of Iran","volume":"4 1","pages":"157-157"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73236602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Khodadost, Khadije Maajani, A. Noroozi, S. Motevalian, M. Naserbakht, F. Sarvi, Roohollah Seddigh, L. Jamshidi, S. Yavari, Malihe Khoramdad, Ebrahim Ghodusi, A. Hajebi
Background: Cigarette smoking is known as a gateway drug for illicit drug use in youth. The objective of this study is to assess the prevalence of cigarette smoking in the college students in Iran. Methods: We searched electronic databases including Scopus, Medline/PubMed, Google Scholar and Web of Science, and national databases such as Magiran, Scientific Information Database, Iranmedex, Medlib, Irandoc, and IranPsych from 1946 to 21st July 2018 without any language restriction using a proper search strategy. We used a random effect model to calculate the pooled prevalence of cigarette smoking in college students in Iran. Chi-square test and I2 index were used to evaluate the heterogeneity between the studies. We used the meta-regression and subgroup analysis to assess the potential source of heterogeneity. Stata software, version 11 (StataCorp, TX) was used for all statistical analysis. Results: We included 60 eligible articles in our study. The pooled prevalence of cigarette smoking at least once in the lifetime was 19% (95%CI: 17-22). The I2 index indicated considerable between-study heterogeneity (I2 =98%, p<0.001). The pooled prevalence of cigarette smoking at least once in the lifetime in males and females was 28% (95% CI: 23-34) and 9% (95% CI: 6-13), respectively. In multivariable meta-regression, a significant association was shown between the year of study (β=-13.1, p=0.011) and sampling method (β=-12.8 p=0.017) and daily use in the last month. Conclusions: Increasing prevalence of smoking among Iranian university students is an important health priority. Increasing preventive and health education programs are recommended.
背景:吸烟被认为是青少年非法使用毒品的入口毒品。本研究的目的是评估伊朗大学生吸烟的流行程度。方法:检索1946年至2018年7月21日期间的Scopus、Medline/PubMed、Google Scholar和Web of Science等电子数据库，以及Magiran、Scientific Information Database、Iranmedex、Medlib、Irandoc和IranPsych等国家数据库，不受任何语言限制。我们使用随机效应模型来计算伊朗大学生吸烟的总流行率。采用卡方检验和I2指数评价研究间的异质性。我们使用元回归和亚组分析来评估异质性的潜在来源。所有统计分析均使用Stata软件，版本11 (StataCorp, TX)。结果:我们纳入了60篇符合条件的文章。一生中至少吸烟一次的总流行率为19% (95%CI: 17-22)。I2指数显示研究间存在显著异质性(I2 =98%， p<0.001)。男性和女性一生中至少吸烟一次的总患病率分别为28% (95% CI: 23-34)和9% (95% CI: 6-13)。在多变量元回归中，研究年份(β=-13.1, p=0.011)和抽样方法(β=-12.8 p=0.017)与最近一个月的每日使用量之间存在显著关联。结论:伊朗大学生吸烟率的上升是一个重要的健康优先事项。建议增加预防和健康教育项目。
{"title":"Prevalence of cigarette smoking among college students in Iran: An updated systematic review and meta-analysis of observational studies.","authors":"M. Khodadost, Khadije Maajani, A. Noroozi, S. Motevalian, M. Naserbakht, F. Sarvi, Roohollah Seddigh, L. Jamshidi, S. Yavari, Malihe Khoramdad, Ebrahim Ghodusi, A. Hajebi","doi":"10.34171/MJIRI.34.165","DOIUrl":"https://doi.org/10.34171/MJIRI.34.165","url":null,"abstract":"Background: Cigarette smoking is known as a gateway drug for illicit drug use in youth. The objective of this study is to assess the prevalence of cigarette smoking in the college students in Iran. Methods: We searched electronic databases including Scopus, Medline/PubMed, Google Scholar and Web of Science, and national databases such as Magiran, Scientific Information Database, Iranmedex, Medlib, Irandoc, and IranPsych from 1946 to 21st July 2018 without any language restriction using a proper search strategy. We used a random effect model to calculate the pooled prevalence of cigarette smoking in college students in Iran. Chi-square test and I2 index were used to evaluate the heterogeneity between the studies. We used the meta-regression and subgroup analysis to assess the potential source of heterogeneity. Stata software, version 11 (StataCorp, TX) was used for all statistical analysis. Results: We included 60 eligible articles in our study. The pooled prevalence of cigarette smoking at least once in the lifetime was 19% (95%CI: 17-22). The I2 index indicated considerable between-study heterogeneity (I2 =98%, p<0.001). The pooled prevalence of cigarette smoking at least once in the lifetime in males and females was 28% (95% CI: 23-34) and 9% (95% CI: 6-13), respectively. In multivariable meta-regression, a significant association was shown between the year of study (β=-13.1, p=0.011) and sampling method (β=-12.8 p=0.017) and daily use in the last month. Conclusions: Increasing prevalence of smoking among Iranian university students is an important health priority. Increasing preventive and health education programs are recommended.","PeriodicalId":22988,"journal":{"name":"The Medical Journal of The Islamic Republic of Iran","volume":"24 1","pages":"165-165"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76224960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-08-10DOI: 10.29011/2575-9760.000188
Hamidreza Aslani, H. Vahedi, Z. Zafarani
Background: Rotator cuff tear is one of the most common causes of shoulder complaints in the elderly. Based on the severity and patient's condition, a variety of methods applies to manage the tear and surgery is an important method, which could be done by open or arthroscopic technique. The current study aimed to investigate and report short-term results of arthroscopic repair of complete rotator cuff tears. Methods: This was a cross-sectional study on 183 patients who underwent arthroscopic surgery to repair rotator cuff tear in three different hospitals of Tehran between January 2003 and August 2006. Of all patients, 107 cases included in our study, which had a complete rotator cuff tear, and at least one-year follow up record. 89 patients (56 male and 33 female) attended assessment sessions and were evaluated by UCLA (University of California, Los Angeles) Shoulder and Elbow Scoring System, pre- and post-operatively, and acromioplasty was performed in 83 patients. Results: With a mean age of 53.2 ± 15.8 (32-71) years, the average UCLA score was 11.3 before the surgery and 31.4 post-operatively. There were 11 patients with excellent scores, 62 good, 11 fair, and 5 poor scores. 9 out of 11 cases with excellent score and 34 out of 62 with good score were younger than 55 years; however, 13 cases were older than 60 years amongst 16 fair or poor scores. Conclusions: Arthroscopic repair of complete rotator cuff tear would cause a significant improvement in a short-term period and results are better in younger patients, through the UCLA scoring system.
{"title":"Arthroscopic repair of complete tear of rotator cuff","authors":"Hamidreza Aslani, H. Vahedi, Z. Zafarani","doi":"10.29011/2575-9760.000188","DOIUrl":"https://doi.org/10.29011/2575-9760.000188","url":null,"abstract":"Background: Rotator cuff tear is one of the most common causes of shoulder complaints in the elderly. Based on the severity and patient's condition, a variety of methods applies to manage the tear and surgery is an important method, which could be done by open or arthroscopic technique. The current study aimed to investigate and report short-term results of arthroscopic repair of complete rotator cuff tears. Methods: This was a cross-sectional study on 183 patients who underwent arthroscopic surgery to repair rotator cuff tear in three different hospitals of Tehran between January 2003 and August 2006. Of all patients, 107 cases included in our study, which had a complete rotator cuff tear, and at least one-year follow up record. 89 patients (56 male and 33 female) attended assessment sessions and were evaluated by UCLA (University of California, Los Angeles) Shoulder and Elbow Scoring System, pre- and post-operatively, and acromioplasty was performed in 83 patients. Results: With a mean age of 53.2 ± 15.8 (32-71) years, the average UCLA score was 11.3 before the surgery and 31.4 post-operatively. There were 11 patients with excellent scores, 62 good, 11 fair, and 5 poor scores. 9 out of 11 cases with excellent score and 34 out of 62 with good score were younger than 55 years; however, 13 cases were older than 60 years amongst 16 fair or poor scores. Conclusions: Arthroscopic repair of complete rotator cuff tear would cause a significant improvement in a short-term period and results are better in younger patients, through the UCLA scoring system.","PeriodicalId":22988,"journal":{"name":"The Medical Journal of The Islamic Republic of Iran","volume":"24 1","pages":"57-63"},"PeriodicalIF":0.0,"publicationDate":"2009-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78846314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2006-05-15DOI: 10.1007/S10353-006-0271-7
S. Kashani, M. Lak, H. Mohebi, Farzad Panahe
{"title":"LATERAL INTERNAL SPHINCTEROTOMY UNDER LOCAL ANESTHESIA: A RANDOMIZED CLINICAL TRIAL","authors":"S. Kashani, M. Lak, H. Mohebi, Farzad Panahe","doi":"10.1007/S10353-006-0271-7","DOIUrl":"https://doi.org/10.1007/S10353-006-0271-7","url":null,"abstract":"","PeriodicalId":22988,"journal":{"name":"The Medical Journal of The Islamic Republic of Iran","volume":"18 1","pages":"37-40"},"PeriodicalIF":0.0,"publicationDate":"2006-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80489612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The provocative effects of sleep deprivation (SD) on patients with seizure disorder and on the electroencephalogram (EEG) are well known.The purpose of the study was to test its routine use and usefulness in the pediatric and adolescent age group with, or suspect of having, seizure disorder, especially those presenting with first unprovoked seizure. Between September 2000 and November 2002, among patients referring to the author's clinic and the Pediatric Emergency Department of Nemazi Hospital, Shiraz, 598 children and adolescents were randomly assigned to a 10-minute surface EEG, either routinely, or after a period of partial or total SD. Those who refused or could not tolerate the SD procedure entered the routine group. The EEG's were analyzed for the presence of epileptic abnormality. Of 598 patients, 544( 91%) had clinical seizures; the rest (54, 9%) were seizure suspects or had seizure "mimickers" (syncope, night terrors, pseudo-seizures, etc). Of seizure patients, 210 ( 38.6 % ) suffered from a first unprovoked seizure, and the rest (334, 61.4%) had more than one seizure episode at the time of EEG performance. Abnormal epileptiform EEG's were more frequently seen in the group of seizure patients who were sleep-deprived before performing the EEG, as compared to the routine group. Conversely, more normal EEG's were seen upon routine performance of EEG ( p value <00001, χ2 = 76.5). Similarly, more abnormal sleep-deprived EEG's were seen in patients with first unprovoked seizure than when EEG was done routinely in this subgroup of patients. Patients with complex partial seizure had significantly more abnormal EEG's when subjected to SD (p<00001). Older patients could tolerate SD better than the younger age group; so more routine EEG's had to be performed in the younger age group.Younger children could only tolerate partial SD. There was no difference in the yield of EEG in patients with absence epilepsy between the two groups. In 5 patients with juvenile myoclonic epilepsy, SD precipitated a generalized tonic-clonic seizure which necessitated acute anti-epileptic drug administration to the seizure activity. All patients with non-seizure episodes showed normal EEG's. In conclusion SD can be safely applied in the work-up of selected pediatric patients with seizure disorder, especially in those with their first unprovoked seizure, in whom an abnormal EEG might dictate anti-epileptic drug therapy. Not all children with seizure disorder need to undergo SD for EEG, as it may not be necessary in some, and intolerable in others. In non-seizure episodes, if used in appropriate pediatric age groups, it can be very helpful to ensure that a seizure disorder is not present.
{"title":"USEFULNESS OF SLEEP-DEPRIVED EEG IN THE DIAGNOSIS OF SEIZURE DISORDERS IN CIDLDREN","authors":"S. Rafiei","doi":"10.1055/S-2006-945869","DOIUrl":"https://doi.org/10.1055/S-2006-945869","url":null,"abstract":"The provocative effects of sleep deprivation (SD) on patients with\u0000seizure disorder and on the electroencephalogram (EEG) are well\u0000known.The purpose of the study was to test its routine use and\u0000usefulness in the pediatric and adolescent age group with, or suspect\u0000of having, seizure disorder, especially those presenting with first\u0000unprovoked seizure. Between September 2000 and November 2002, among\u0000patients referring to the author's clinic and the Pediatric Emergency\u0000Department of Nemazi Hospital, Shiraz, 598 children and adolescents\u0000were randomly assigned to a 10-minute surface EEG, either routinely, or\u0000after a period of partial or total SD. Those who refused or could not\u0000tolerate the SD procedure entered the routine group. The EEG's were\u0000analyzed for the presence of epileptic abnormality. Of 598 patients,\u0000544( 91%) had clinical seizures; the rest (54, 9%) were seizure\u0000suspects or had seizure \"mimickers\" (syncope, night terrors,\u0000pseudo-seizures, etc). Of seizure patients, 210 ( 38.6 % ) suffered\u0000from a first unprovoked seizure, and the rest (334, 61.4%) had more\u0000than one seizure episode at the time of EEG performance. Abnormal\u0000epileptiform EEG's were more frequently seen in the group of seizure\u0000patients who were sleep-deprived before performing the EEG, as compared\u0000to the routine group. Conversely, more normal EEG's were seen upon\u0000routine performance of EEG ( p value <00001, χ2 = 76.5). \u0000Similarly, more abnormal sleep-deprived EEG's were seen in patients\u0000with first unprovoked seizure than when EEG was done routinely in this\u0000subgroup of patients. Patients with complex partial seizure had\u0000significantly more abnormal EEG's when subjected to SD (p<00001). \u0000Older patients could tolerate SD better than the younger age group; so\u0000more routine EEG's had to be performed in the younger age group.Younger\u0000children could only tolerate partial SD. There was no difference in the\u0000yield of EEG in patients with absence epilepsy between the two groups.\u0000In 5 patients with juvenile myoclonic epilepsy, SD precipitated a\u0000generalized tonic-clonic seizure which necessitated acute\u0000anti-epileptic drug administration to the seizure activity. All\u0000patients with non-seizure episodes showed normal EEG's. In conclusion\u0000SD can be safely applied in the work-up of selected pediatric patients\u0000with seizure disorder, especially in those with their first unprovoked\u0000seizure, in whom an abnormal EEG might dictate anti-epileptic drug\u0000therapy. Not all children with seizure disorder need to undergo SD for\u0000EEG, as it may not be necessary in some, and intolerable in others. In\u0000non-seizure episodes, if used in appropriate pediatric age groups, it\u0000can be very helpful to ensure that a seizure disorder is not present.","PeriodicalId":22988,"journal":{"name":"The Medical Journal of The Islamic Republic of Iran","volume":"29 1","pages":"21-28"},"PeriodicalIF":0.0,"publicationDate":"2004-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85678338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Alaei, M. Huotari, P. Piepponen, L. Ahtee, O. Hänninen, P. Männistö
Drug addiction has developed to a social illness. Changes in glutamate transmission have been recorded by the repeated administration of addictive drugs into VTA. In this investigation, In vivo microdialysis was used to study the effects of morphine on glutamate release from the ventral tegmentum area (VTA) in freely moving rats. Rats were anesthetized with chloral hydrate (350 mg/kg, i.p.) and placed in a Kopf stereotaxic apparatus. A vertical guide cannula was implanted through a burr hole and secured with dental cement held on the skull with small screws. The final co-ordinates for the tip of the microdialysis probe in right VTA relative to bregma were: anteroposterior (AP), 5.8; lateral (L), 0.5 and dorsoventral (DV), 9.0 according to atlas of Paxinos. One week after surgery, the microdialysis probe was inserted into the guide cannula and perfused with artificial cerebrospinal fluid (aCSF). After a 60 min wash out period, dialysate samples were collected in 20 min periods in vials and 20?m was used for glutamate HPLC analysis. Intraperitoneal (IP) injection of acute and repeated administration of morphine at increasing doses enhanced significantly glutamate release. Only a minor tolerance developed to this effect of morphine. AP-5 (2-amino-5-phosphonovaleric acid, 0.5 mg/kg i.p.), a NMDA receptor antagonist, given 20 min before each repeated morphine injection, did not have a significant effect on the stimulated glutamate release. Conversely, injection of CNQX (6-cyano-7-nitroquinnoxaline-2, 3-dione, 0.5 mg/kg i.p), an AMPA receptor antagonist, 20 min before each morphine dose was found to markedly inhibit morphine-induced glutamate release in the VTA. In all experiments, release of glutamate reduced by time. These results show for the first time that acute and repeated injection of morphine stimulates glutamate release in the conscious rat VTA via AMPA receptors.
{"title":"MORPHINE RELEASES GLUTAMATE THROUGH AMPA RECEPTORS IN THE VENTRAL TEGMENTAL AREA: A MICRODIALYSIS STUDY IN CONSCIOUS RATS","authors":"H. Alaei, M. Huotari, P. Piepponen, L. Ahtee, O. Hänninen, P. Männistö","doi":"10.22037/IJPR.2010.109","DOIUrl":"https://doi.org/10.22037/IJPR.2010.109","url":null,"abstract":"Drug addiction has developed to a social illness. Changes in glutamate transmission have been recorded by the repeated administration of addictive drugs into VTA. In this investigation, In vivo microdialysis was used to study the effects of morphine on glutamate release from the ventral tegmentum area (VTA) in freely moving rats. Rats were anesthetized with chloral hydrate (350 mg/kg, i.p.) and placed in a Kopf stereotaxic apparatus. A vertical guide cannula was implanted through a burr hole and secured with dental cement held on the skull with small screws. The final co-ordinates for the tip of the microdialysis probe in right VTA relative to bregma were: anteroposterior (AP), 5.8; lateral (L), 0.5 and dorsoventral (DV), 9.0 according to atlas of Paxinos. One week after surgery, the microdialysis probe was inserted into the guide cannula and perfused with artificial cerebrospinal fluid (aCSF). After a 60 min wash out period, dialysate samples were collected in 20 min periods in vials and 20?m was used for glutamate HPLC analysis. Intraperitoneal (IP) injection of acute and repeated administration of morphine at increasing doses enhanced significantly glutamate release. Only a minor tolerance developed to this effect of morphine. AP-5 (2-amino-5-phosphonovaleric acid, 0.5 mg/kg i.p.), a NMDA receptor antagonist, given 20 min before each repeated morphine injection, did not have a significant effect on the stimulated glutamate release. Conversely, injection of CNQX (6-cyano-7-nitroquinnoxaline-2, 3-dione, 0.5 mg/kg i.p), an AMPA receptor antagonist, 20 min before each morphine dose was found to markedly inhibit morphine-induced glutamate release in the VTA. In all experiments, release of glutamate reduced by time. These results show for the first time that acute and repeated injection of morphine stimulates glutamate release in the conscious rat VTA via AMPA receptors.","PeriodicalId":22988,"journal":{"name":"The Medical Journal of The Islamic Republic of Iran","volume":"12 1","pages":"225-232"},"PeriodicalIF":0.0,"publicationDate":"2003-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87241875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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